An evaluation of a hierarchical method of describing the pattern of dental caries attack

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Abstract
A number of procedures have been developed to reduce the time needed to examine and record dental caries in epidemiologic studies. One such method is described in a 1967 draft of a WHO Manual. The present report is an evaluation of that method, and is based on analysis of data from 2,123 individuals 6 to 17 years old examined in three previous studies. The method is based on assigning individuals to one of five zones of increasing severity, assuming that once an individual is classified into a given zone, he automatically belongs to all zones of lesser severity (except zero). The analysis carried out in this study shows that Zones 2 and 3 as well as Zones 4 and 5 have to be combined in order for the above mentioned assumption to be fullfilled. Furthermore, it is shown that there is good agreement between information on severity of dental caries attack obtained by this method and measurements of dental caries prevalence obtained by conventional methods (DMF). Finally, it is demonstrated that the modified method is sensitive enough to be able to detect the caries preventive effect of fluoridation of school water supplies.